Prognostic value of pretreatment serum levels of lactate dehydrogenase in nonmetastatic nasopharyngeal carcinoma: single-site analysis of 601 patients in a highly endemic area

Figures & data

Table 1 Patient characteristics

Characteristic	n (%)	Pretreatment serum LDH (U/L, mean ± SD)	P-value
Age (years)
≤50	436 (74.1)	186.95±88.19	0.149
>50	165 (25.9)	198.37±83.14
Sex
Male	440 (76.2)	188.98±69.92	0.683
Female	161 (23.8)	193.12±121.14
Tumor classification
T1+2	379 (62.0)	184.09±70.04	0.039
T3+4	222 (38.0)	201.06±109.10
Lymph node classification
N0+1	421 (70.1)	178.85±53.68	0.000
N2+3	180 (29.9)	216.91±131.72
TNM stage (AJCC)
I + II	262 (43.6)	171.27±47.86	0.000
III + IV	339 (56.4)	205.14±105.41
Smoking history
Yes	136 (24.1)	189.40±68.42	0.915
No	465 (75.9)	190.29±91.27
Chemotherapy
Yes	338 (58.4)	196.14±97.87	0.067
No	263 (41.6)	182.52±69.81
EBV-related antibodies
Negative	44 (7.3)	199.56±81.48	0.531
Positive	539 (89.7)	190.45±88.13
NA	18 (3.0)
Family history of NPC
Yes	25	195.80±75.16	0.737
No	576	189.84±87.08

Abbreviations: AJCC, American Joint Committee on Cancer; LDH, lactate dehydrogenase; EBV, Epstein-Barr virus; NA, not available; NPC, nasopharyngeal carcinoma; SD, standard deviation; TNM, tumor nodes metastasis-classification.

Figure 1 Survival analysis of 601 patients with nasopharyngeal carcinoma stratified by pretreatment serum levels of lactate dehydrogenase (≤5 or >225 U/L).

Notes: (A) Overall survival (P<0.0001). (B) Tumor-free survival (P=0.002).

Table 2 Cox multivariate analysis to identify prognostic factors in 601 patients with nasopharyngeal carcinoma using a cutoff of 225 U/L to define low and high S-LDH levels

Prognostic factor	P-value	HR	95% CI for HR
Overall survival
Pretreatment S-LDH	0.002	1.724	1.221–2.434
Age	0.007	1.547	1.125–2.127
T classification	0.001	1.362	1.160–1.599
N classification	0.004	1.243	1.071–1.442
Tumor-free survival
Pretreatment S-LDH	0.014	1.482	1.084–2.028
Age	0.006	1.487	1.121–1.973
T classification	0.004	1.228	1.067–1.415
N classification	0.014	1.825	1.127–2.955

Abbreviations: HR, hazard ratio; CI, confidence interval; S-LDH, serum lactate dehydrogenase.

Table 3 Cox multivariate analysis to identify the prognostic value of pretreatment S-LDH levels in patients with early-stage or late-stage nasopharyngeal carcinoma based on a cutoff of 225 U/L to define low or high S-LDH

Pretreatment S-LDH	Stage I + II (AJCC)			Stage III + IV (AJCC)
	P-value	HR	95% CI for HR	P-value	HR	95% CI for HR
OS	0.160	1.748	0.803–3.805	0.009	1.693	1.139–2.517
TFS	0.222	1.525	0.775–3.003	0.021	1.533	1.068–2.201

Abbreviations: AJCC, American Joint Committee on Cancer; HR, hazard ratio; CI, confidence interval; OS, overall survival; S-LDH, serum lactate dehydrogenase; TFS, tumor-free survival.

Table 4 Cox multivariate analysis to identify prognostic factors in 262 patients with stage I + II nasopharyngeal carcinoma using a cutoff of 171 U/L to define low and high S-LDH levels

Prognostic factor	P-value	HR	95% CI for HR
Overall survival
Pretreatment S-LDH	0.018	1.945	1.123–3.367
Age	0.039	1.799	1.031–3.137
Tumor-free survival
Pretreatment S-LDH	0.007	1.866	1.182–2.944
Age	0.001	2.170	1.371–3.434

Abbreviations: HR, hazard ratio; 95% CI, 95% confidence interval; S-LDH, serum lactate dehydrogenase.

Figure 2 Survival analysis of 262 patients with stage I + II nasopharyngeal carcinoma stratified by pretreatment serum levels of lactate dehydrogenase (≤ or >171 U/L).

Notes: (A) Overall survival (P=0.005). (B) Tumor-free survival (P=0.002).